1.

Menstrual Migraine
- Menstrual migren tanpa aura, dengan onset saat premenstrual ( 2 – 3 hari
sebelum menstruasi)
- Harus ada pada 2/3 siklue menstruasi
- Patof : decline in serum estradiol level that occur shortly before or during
premenstrual time
o Release of prostaglandin from a shedding endometrium that sensitizes
peripheral nociceptors
o Decline in serum magnesium levels
o Decrease in ninnhibitory neurotransmitter systems that modulate
neuronal firing rates within second order neurons of the trigeminal
system
- Tatalaksana :
o Abortive : prevent development once it has begun
 Migraine specific (migraine and cluster headache) : triptans and
ergots
 Migraine non spesifid (both migraine and tension-type
headache) : NSAID, acetaminophen, narcothic
o Presentative : prevent the development of menstrual migraine altogether
 Short term : NSAID, triptans estrogen transdermal patch
 Continuous : long duration oral contraceptives and gonadotropin
releasing hormone agonist

2. Kejang
- Kejang parsial  aktivitas nrual yang abnormal localized to one area of the
cerebral hemisphere and having a discernible focal or localized onset
o Simplex : gaada gangguan kesadaran
o Complex : ada gangguan kesadaran
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3. Skor :
- >+1 : stroke hemoragik
- <-1 : stroke iskemik
- (-1) – (+1) : dibutuhkan pemeriksaan head CT scan

MAP : (2(DBP) + SDP) / 3

Sasaran tekanan darah 2tutunn 20%